| NPI | 1366715658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MOORE Psychotherapist/Owner 479-313-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AR P1009062) |
| Additional Taxonomies | 251S00000X (Licence: AR M1201002) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2015-02-27 |